Dr. Muhammad Almas Hashmi

Dr. Muhammad Almas Hashmi

Introduction

Experienced Paediatrician and Paediatric Gastroenterologist & Hepatologist with a demonstrated history of working in the medical practice industry. Skilled in Paediatric Endoscopy,, Healthcare, and Medical Research. Strong healthcare services professional graduated from Rawalpindi Medical College.and cuurntly working at Fauji Foundation Hospital Rawalpindi, Foundation University Islamabad.

Authors:

Introduction: Esophageal stricture is a common and horrible complication of corrosive ingestion. Injury incurred by the corrosive and repeated therapeutic dilations; followed by healing, results in fibrosis and scarring and ultimately recurrence. Mitomycin-C is an anti-neoplastic and anti fibroblast agent with potential to decrease fibrosis and has shown favorable results of in reducing scar formation after stricture dilation.
Materials & Methods: This Interventional Case Control Study was carried out in the Department of Pediatric Gastroenterology Hepatology & Nutrition at The Children’s Hospital & Institute of Child Health, Lahore. Post-caustic esophageal stricture patients presenting in year 2013, were included in Mitomycin-C group. They were compared with a control group including patients of post-corrosive esophageal stricture presenting in year 2012. All patients underwent endoscopic balloon dilatations. Outcomes in terms of symptomatic relief and numbers of dilatations required were compared between the two groups.
Results: Total 81 patients (51 male, 30 female) were included in study. Out of these; 38 patients were in Mitomycin-C group, while 43 were in control group. In Mitomycin-C group, 1.6 dilatations per patient were done; while in control group 2.67 dilatations per patient were done (P value 0.026). Minimum asymptomatic interval between dilatations was increased in Mitomycin-C group (P-value 0.00).
Conclusion: Application of topical Mitomycin-C after balloon dilation of post-corrosive esophageal stricture results in significantly reduced number of dilation sessions required and increases the asymptomatic period.
Key Words: Mitomycin-C, Esophageal stricture, Balloon dilation

Authors:

ABSTRACT… Objectives: Probiotics are alive organisms which confer health benefit when
taken at an appropriate dosage. This study was done to determine the efficacy of probiotics in
decreasing the frequency of diarrhea in children with celiac disease. Study Design: Randomized
controlled trial. Setting: Department of Pediatrics/DHQ Allied Hospital, Faisalabad. Period:
November 2011 to October 2012. Methods: Newly diagnosed patients with CD having diarrhea
were included by consecutive non-probability sampling. Patients were randomized in two
groups using computer generated numbers. One group was given probiotic along with gluten
free diet while other was only prescribed gluten free diet. Reduction in frequency of diarrhea in
two groups was compared after a period of 28 days. Results: A total of 116 cases (58 in each
group) were enrolled. Mean age was 9.11 years. The groups were similar in age and gender of
patients. Comparison of efficacy of probiotics in children with CD was done with control group
which revealed reduction in stools frequency to less than half in 86.21% (n=50) in probiotic
group but only 62.07% (n=36) in control group. P-value was 0.00015 which shows a highly
significant difference in both groups. Conclusion: Probiotics in addition to gluten free diet are
highly effective in reducing the frequency of diarrhea in newly diagnosed patients with CD, in
comparison with gluten free diet alone.
Key words: Celiac Disease, Children, Management, Probiotic, Efficacy

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